ACOFP 2025 Health Policy
Advocacy Priority Number One
Reduce Unnecessary Paperwork Requirements
Cumbersome electronic health record (EHR) systems, utilization management policies, (e.g., prior authorization), and continuously changing regulatory rules are forcing physicians to spend more time on administrative tasks rather than spending time with patients. Even more time is spent on these burdensome tasks after hours. According to recent studies, physicians spend approximately half of their time working on EHRs and administrative work, in addition to completing paperwork after hours. In a 2023 study, 89 percent of practices surveyed responded that prior authorization requirements are, “very or extremely burdensome.”[i] Another study revealed that for every hour a physician spends on clinical time, nearly two hours are spent on EHR and administrative tasks every day.[ii]
Burdensome paperwork requirements are contributing to the physician shortage and are inhibiting appropriate patient care.[iii] Many physicians, burned out by paperwork requirements, retire early or leave medical practice for another profession, especially those in small, rural, and solo practices where they do not have the resources to manage all the paperwork requirements.[iv] As more of these practices are forced to close or relocate, healthcare shortages increase, and more communities lose access to care.
Artificial Intelligence (AI), including augmented intelligence, has the potential to decrease burnout rates given its ability to assist with providing care and reduce time and resources spent on administrative tasks. Specifically, studies illustrate that AI has the potential to deliver value to physicians by automating routine tasks, streamlining critical workflows, and relieving administrative burdens.[v] ACOFP supports AI as a tool to reduce administrative burden and address physician burnout. However, AI cannot replace the physician-patient relationship that is integral to patient care. Therefore, guardrails are necessary to ensure that physicians remain the ultimate clinical decision-makers when it comes to patient care.
Moreover, while AI can provide many benefits, we are concerned that what AI produces could misrepresent patient conditions. Physicians therefore must continue to play an active role in patient care to ensure AI products are accurate.
ACOFP also recognizes that AI can be expensive to deploy and that such costs could be a barrier to adoption for small, rural, and solo practices. We support policies that promote access to AI for small, rural, and solo practices so that physicians in practices of all sizes and in all geographic locations receive equal access and are not prevented from accessing tools that can reduce administrative burden.
Although federal programs like the Medicare Quality Payment Program (QPP) and value-based care payment models are intended to improve health outcomes and reduce spending, these initiatives have significantly increased administrative burdens for physicians. The U.S. Centers for Medicare & Medicaid Services (CMS) has taken steps to reduce paperwork requirements through programs like the Patients Over Paperwork initiative and the creation of offices such as the Office of Burden Reduction and Health Informatics,[vi] in addition to developing outcome measures that are clinically appropriate through the Meaningful Measures Framework. While ACOFP appreciates CMS’s commitment to allowing more time to be devoted to providing care, more action needs to be taken to achieve the goals of these programs and to reduce administrative burdens.
Through the U.S. Health Resources and Services Administration (HRSA), the U.S. Department of Health and Human Services (HHS) announced plans to distribute $103 million from the American Rescue Plan Act of 2021 (ARPA) over a three-year period to strengthen resiliency and address burnout in the health workforce. ACOFP supports funding efforts to address physician burnout and promote physician wellness to establish a culture of wellbeing among the physician community.
Advocacy Positions:
- Reduce burdensome paperwork requirements across federal programs to allow physicians to spend more time treating patients.
- Maintain and expand CMS’s efforts to reduce administrative burden, such as the Patients Over Paperwork initiative.
- Require EHR interoperability and standardize reporting requirements to reduce time spent on EHRs.
- Develop meaningful EHR reporting requirements to replace those that do not contribute to patient outcomes.
- Allow physicians to be reimbursed promptly for time spent preparing for patient visits and logging medical information into the electronic medical record beyond the day of the patient visit.
- Streamline utilization management policies across payers in a way that all stakeholders can quickly and efficiently address patient needs.
- Thoughtfully implement any major regulatory changes to Medicare to increase program certainty and to ensure that physicians have time to familiarize themselves with new program rules and update their practices accordingly.
- Support the use of AI as a tool to reduce administrative burden but with restrictions to preserve the physician-patient relationship as well as the physician’s ultimate clinical decision-making authority.
- Support policies that ensure AI is accessible to all physicians, including those in small, rural, and solo practices.
[i] Medical Group Management Association. Annual Regulatory Burden Report. November 2023. Available at https://www.mgma.com/getkaiasset/423e0368-b834-467c-a6c3-53f4d759a490/2023%20MGMA%20Regulatory%20Burden%20Report%20FINAL.pdf
[ii] Sinsky C., Colligan L., Li L., et al. Allocation of physician time in ambulatory practice: A time and motion study in 4 specialties. Ann Intern Med. 2016;165(11):753–760. doi:10.7326/M16-0961
[iii] Top challenges 2021: #1 administrative burdens and paperwork. Medical Economics. 2021;98(1):7–8. Accessed January 12, 2023. https://www.medicaleconomics.com/view/top-challenges-2021-1-administrative-burdens-and-paperwork
[iv] Freeman L. Is your doctor at risk? Burnout could drive physicians from field, jeopardize patient. Northwest Florida Daily News. December 1, 2021. Available at https://advance.lexis.com/api/permalink/c8add16f-3f89-498f-be29-ae05fcda77a0/?context=1000516
[v] athenahealth, Almost All U.S. Physicians Surveyed Feel Burned Out on a Regular Basis, with Many Having Considered Career Change, according to Recent athenahealth Physician Sentiment Survey. February 21, 2024. Available at https://www.athenahealth.com/press-releases/us-physicians-surveyed-feel-burned-out-on-a-regular-basis.
[vi] Centers for Medicare & Medicaid Services. Office of Burden Reduction and Health Informatics. Functional statement. Last modified December 12, 2021. Accessed January 12, 2023. https://www.cms.gov/About-CMS/Agency-Information/CMSLeadership/Office_OBRHI